Saturday, January 17, 2015

Great Expectations (by Lianne Wood)

Guest Post: Lianne Wood (nee Wicks)

Lianne is a buddy from university. She has been reading my blog when she gets a gap, and was keen to write a post but had decided to write to me two nights ago to say she didn't have the time. Instead she wrote the post. I am really glad she did. Finding time for the things we want to do is tough. Finding time for those annoying little admin task that we don't want to do is tough. Almost everyone I know is really busy. Time is priceless and is the one thing we all have exactly the same amount of each day. Lianne is a physio. I am a big believer that sorting our bodies out so we give them every chance to function as well as possible is a core foundation of happiness. So I am super chuffed to get her insight. Lianne has always had the positive mindset that she identifies as making such a difference in her patients. Add that to being great with people and it is no surprise that she has found a path that brings her joy.

Great Expectations
by Lianne Wood

I am a physiotherapist and have been one of those fortunate enough to love what I do. I had the opportunity to run my own private practice in South Africa, and have now been working as an extended scope physiotherapist with a special interest in chronic pain and spinal conditions in the UK. The mainstay of my job in the Spinal Disorders Unit is to assess patients when they are referred to us, assess whether they need further investigations (blood tests, imaging etc.) and then to decide if their diagnosis is an operable one or one that would be best managed by conservative therapy (i.e. physiotherapy etc.).

Every day I meet patients who have terrible spines on imaging and yet are in a minimal or manageable amount of pain. And then I meet those who are in terrible pain and yet have nothing to find on imaging. Of course, there are always those in between, whose symptoms match those on scans, and they are the ones we offer injections to or surgery, and sometimes they still choose to continue with physiotherapy or no intervention as they are mending on their own.

Which brings me to the question, what makes the difference between these essentially two separate groups of patients? It's something we as a health profession have tried with no real success to understand, and it seems to confirm that we are indeed holistic beings, with emotional affect and psychological impact on our being. Now by all means, I do not mean to detract from those that are in severe pain, but it fascinates me how some people have found a way to cope with severe pathology and have apparently minimal impact on their life. Is this a case of them having better support systems in their life so that they can cope with more? Is it a case of them having an inherently greater capacity to cope with more stress/pain than others? Is it simply that due to the pathology being more severe, the body has compensated over time and therefore the impact on the body as a whole is less?

I know there is no one answer to these questions, but something I do see time and time again with my patients, is that often what brings them the most relief is helping them to adjust their expectations. If they know what their diagnosis or prognosis is, very often they are then happy to continue managing their pain, as long as they have the peace of mind that they can understand its natural course. Sometimes this is not so simple, and I end up having to help them to understand the complexities of chronic pain (read more about this here - a colleague's brilliant blog on language and chronic pain) but sometimes it is as simple as being heard and reassured.

Which brings me to the thread of this blog, is our happiness determined by our expectations for ourselves? Early on in my undergraduate studies when I was still wrestling with who I was and who I wanted to become, I was told that the career path I took wasn't important. It was what I did with that career that made the difference to my happiness state. I can honestly say there were many days in my early career when I wished I had studied something else, challenged myself in different ways. However, the more I have embraced my career path, the more it has rewarded me and given me incredible satisfaction, both intellectually and emotionally. I do think that our expectations are key to our happiness, and if these can be managed appropriately and realistically, be it with regards to our health, careers or even love, we are much more likely to be happy with ourselves and our lives.


In writing a blog about several topics in which I admit to being a complete beginner, I am going to have to rely heavily on the people I am writing for who cumulatively know most of what I am likely to learn already. I would love it if some of you found the time to write a guest post on the subject of happiness or learning. The framework I use for thinking about these things is what I call the '5 + 2 points' which includes proper (1) exercise, (2) breathing, (3) diet, (4) relaxation, (5) positive thinking & meditation, (+1) relationships, (+2) flow. Naturally if you would like to write about something that you think I have missed, I would love to include that too. If you are up to doing something more practical, it would be awesome if you did a 100 hour project and I am happy to do the writing based on our chats if that is how you roll. Email me at 

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